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Organization
ALTERNATIVE ADULT CARE
Active
Organization
ALTERNATIVE ADULT CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MAGARET W COUSIN RN (EXECUTIVE DIRECTOR)
(804) 427-6966
Entity
Organization
Contact information
Practice address
7193 BROOKING WAY, MECHANICSVILLE, VA 23111-5059
(804) 427-6966
Mailing address
7193 BROOKING WAY, MECHANICSVILLE, VA 23111-5059
(804) 427-6966
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
CLO-06-1103628
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008730598
—
VA
Enumeration date
07/06/2007
Last updated
12/11/2015
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